Surgeons have used laparoscopic surgery to perform a variety of procedures. By manipulating laparoscopes and video telescopes, surgeons gain a visualization of the abdominal cavity while minimizing tissue and muscle injury that normally accompanies conventional invasive procedures. Compared to conventional surgery, laparoscopy reduces patient trauma, decreases patient recovery time, and yields significant cost savings by reducing post-operative care.
The proper hardware and instrumentation are essential to the performance of laparoscopic procedures. To create a sufficient area for the introduction of a laparoscope and other instruments, the abdominal wall is first raised from the organs enclosed in the abdominal cavity. Separation is conventionally attained by pressurizing the abdominal cavity with an insufflation gas. Typically, carbon dioxide or nitrous oxide is used. The presence of artificial gas in the peritoneal cavity to achieve exposure during laparoscopy is referred to as pneumoperitoneum.
When maintaining pneumoperitoneum, it is desirable on occasion to infuse the insufflation gas into the cavity at a rate typically above 20 liters per minute. Achieving this rate, however, often is difficult. One of the primary limitations in providing higher flows of insufflation gas are the constraints placed upon the insufflation equipment by both common industry practice, efficacy requirements, and guidance documents issued by the United States Food and Drug Administration concerning issues such as push pressures, pressure duration, overshoot, and pressure relief. Insufflators normally are limited to a push pressure of about 45 to 55 millimeters of mercury. This limitation makes it very difficult to infuse insufflation gas at the desired higher flow rates. Furthermore, the equipment associated with laparoscopic procedures, including the use of standard single PVC tubing, sub-micron filters, and standard laparoscopic equipment such as fixed and rotating collar luers, verres needles, and trocars further restrict the infusion rate of the insufflation gas.
Several techniques have been used to attempt to overcome these limitations. One technique is to use an insufflator with two separate supply sources of insufflating gas, with each providing up to 20 liters or more of flow per minute. This type of insufflator allows high flow rates to be provided so that pneumoperiteum may be maintained. This type of insufflator, however, requires an insufflator capable of creating and controlling separate flow paths within the insufflator, and as a result increases the costs and complexity associated with the insufflator.
Another approach has been to create very large, low restriction paths within an insufflator, large output lines on the front of the insufflators. This type of insufflator, however, requires the use of much larger, non-standard tubing. Also, non-standard, large-opening, expensive trocars and or verres needles are required. Presently, these are not readily available or are not disposable as are the instruments currently in use.
Accordingly, it is desirable to have a device that overcomes the disadvantages and limitations described above.